Table 5.

Priority Areas and Proposed Interventions to Reduce Disparities in Diabetes Care Delivery Across Johns Hopkins Health System

Johns Hopkins Hospital Glucose Management Program Conceptual Framework Component*	Gap Analysis Tool Component	Primary Identified Gap	Interventions
Centralized Glucose Management Program	Program Infrastructure	Only one hospital with centralized Inpatient Glucose Management Program and Steering Committee Variability in diabetes clinicians Variability in clinical information system used Lack of data analysis support at all hospitals Lack of diabetes-focused practitioners at each institution Lack of uniform podiatry services	Identified and hired endocrinologist at one of our community hospitals to serve as physician champion and chair of its Glucose Steering Committee Obtained institutional support to expand ambulatory diabetes services at our 2 academic hospitals Conversion of all 5 adult hospitals to one clinical information system (Epic) Developing a health system analytic plan with Epic data To be addressed To be addressed
Development and Implementation of Glucose Management Program	Protocols, Policies, and Order Sets	Lack of standardization in glucose management policies and practice	Harmonized Epic intravenous and subcutaneous insulin order sets and policies Integration of ambulatory diabetes management algorithm in Epic Plan to organize institutional-level Glucose Steering Committee to oversee ongoing protocol, policy, and order set harmonization
Improved Knowledge	Health Care Professional Education	Lack of standardized approach to training health professionals on inpatient glucose management	National Institutes of Health-funded grant to: Disseminate standardized approach to nursing and allied health professional education via the nursing diabetes superuser curriculum Develop and disseminate standardized approach to physician education via a prescriber diabetes superuser curriculum
Improved Knowledge	Patient Education	No significant gap identified	—
Evaluate Glucose Management Program	Automated Data Access	Lack of standardization in obtaining glucose management, economic, and quality diabetes elements	Developing a systemwide diabetes dahboard to include standardized clinical and economic parameters extractable from Epic

^*See Reference 3.